When Jonathan Mann and his team launched the first post-graduate course on health and human rights offered in an academic setting, at the Harvard School of Public Health 15 years ago, many wondered if there was a real place for such a subject in higher education.1 Was “health and human rights” a science, a discipline, a method, an advocacy line or an ill-defined assembly of concepts that would probably turn students away in favour of “harder” public health matters such as epidemiology and statistics? A student in one of Mann’s classes argued that, indeed, public health “attached much more importance to P-values than to values” and that, in many respects, a health and human rights course was opening a new thread of reflection on the value of public health policies and action. Since that time, courses on the subject have flourished. In 2006, an (incomplete but growing) inventory of courses on health and human rights in academic and other settings listed 57 such courses in 24 institutions.2,3 This count does not include regular or ad hoc courses now offered in developing countries, whether these are targeted at students, public health practitioners or members of civil society. No doubt, the offers of education and training opportunities in health and human rights have fast expanded and so has the demand.

The second volume of Santé et droits humains by Véronique Zesiger et al. brings one more piece to the set of educational materials available from multiple sources, mostly although not exclusively in the English language. Intended primarily for health practitioners and written by a solid group of co-authors, this 215 page book, published in French, incorporates a succinct introduction laying out essential concepts, principles and mechanisms relevant to the congruence – some would say the synergy – between public health and human rights. Ten case studies follow, each constructed around clearly set learning objectives, including questions to be addressed, highlights of the public health issue and references to specific human rights relevant to the case study, sources of pertinent information and bibliography. In all, the book delivers what its title promises: “Learning through examples – case studies as tools for apprenticeship”. Its publication in French makes it a valuable tool for education and training in Francophone countries, including the 10 African countries for which the course material was originally designed under a sponsorship by the Direction du Développement et de la Coopération Suisse. Francophone African countries have suffered for many decades from availability of translated materials that are commonly first published in English and seldom translated into other languages. This book helps bridge this persisting language gap.

The case studies focus on major public health issues such as maternal mortality, female genital mutilation, access to medicine and prison health. They constitute a useful tool for classroom education as well as self-learning. As Internet access expands in low- and medium-income countries, the material presented could serve to structure a distance-learning facility (a field in which one of the co-authors specializes) with interactivity between learners and their mentors. This transition would give the authors an opportunity to further improve the printed publication, in particular its formatting and layout, which are rather poor, the occasional disharmony in the depth of the case studies, and the amount and type of reference information.

More substantively, the book could have been more succinct when listing human rights concerned by each case study. It could also have been more explicit on the practical application of these rights by providing specific reference to their core contents and monitoring indicators, information of practical value to both public health practitioners and human rights defenders. Also lacking emphasis are two concepts central to the practical application of analytical and action-oriented frameworks for health and human rights. The first is the principle of progressive realization applicable to certain rights, a concept that is so relevant to resource-constrained settings. The other is the principle of legitimate derogations on rights, which would have, among few other ambiguities encountered in the book, helped query the appropriateness of compulsory immunization as an example of the potentially nefarious impact of public health policy on human rights. But these are not insurmountable shortcomings. Beyond the rhetoric of health and human rights, evaluating the effectiveness of the series of case studies against their learning objectives will give the true measure of their success. ■

Daniel Tarantola a

a. School of Public Health and Community Medicine, The University of New South Wales, Sydney, NSW 2052, Australia.